Question # 1

In Ontario, what percentage of children and youth between the ages 4-16 suffer from some type of mental illness?

The Answer?

20%

Question # 2

What is the second* most common cause of death in teens?

(*the #1 cause is accidental death)

Suicide

The Answer?

Question # 3

What percentage of individuals who are depressed respond to treatment?

80-90%

The Answer?

Question # 4

Can you name three negative things people with mental illness or mental health difficulties might have to face?

Stigma

Alienation

Misunderstanding

The Answer?

What is mental health?Mental health can be measured by how well we cope with stress, relate to others and make choices. Mental

health is important at every stage of life, from childhood and adolescence through adulthood.

Mental Health is how we…

FeelFeel – feelings, sentiments, moods, sensitivity, affection, attachment, and relationships (self and others)

ThinkThink – thinking, memory, learning, language, decision making, problem solving, understanding, point of view, and relationships (self and others)

ActAct – actions, deeds, activities, manners, conduct, performance, and relationships (self and others)

Mental Health

Mental health relates to feeling good, both mentally and physically. When you are mentally

healthy, you are generally high functioning in your thinking, behavior, and feelings. You may

have your ups and downs, but your general state of being is good.

Mental Health Difficulties

Mental health difficulties can range from temporary reactions to a painful event or stress, symptoms of drug or alcohol use, lack of sleep, etc. right through to more severe psychiatric conditions and mental illness, such as depression and anxiety.

Mental Health Difficulties

Some factors that may contribute to mental health difficulties include:

• The environment

• Personal life experiences

• Your physical body

Major Mental Health Problems

PsychosisMoodAnxietyPersonalityAddictionEating Disorders

Psychosis, disturbance of thinking

Hallucinations Delusions Disorganized

• Behaviors• Thinking• Speech (incoherence)• Movement - Catatonia

Pathways to Psychosis

Mental Illness• Schizophrenia, Schizoaffective Disorder • Bipolar Mania, Severe depression• Paranoid and Borderline Personality Disorders

Substances• e.g. Stimulants, Cannabis

Brain Injuries / Medical Disease• e.g. Alzheimer's

Treatment of Psychosis

MedicationSkill Building

• Social networks for support• Medication Compliance• Occupational support and job• Relapse prevention / Stress Management

Commonly Held Misconceptions of Mental Illness

People with mental illness are always violent and dangerous

People with mental illness are somehow responsible for their condition

People with mental illness have nothing positive to contribute• We need to reduce the stigma associated with mental illness. • We need to develop a strong sense of understanding,

empathy, compassion and tolerance

Common Myths and Mental Illness

Myth #1

You can always tell when someone is experiencing mental illness

FactNot all people who look

or act differently are mentally ill. Some people exhibit eccentric behaviour as a matter of choice and not because of mental illness.

Myth #2

Mental illnesses are long-term illnesses.

FactMental illness is not

necessarily long term. Some mentally ill people may have several episodes of mental illness in their lifetime while having long periods of healthy living in between.

Myth #3

Mental illness is associated with a low level of intelligence.

Fact

On the contrary, people with mental illnesses are of average or above average IQ.

Mental Health Disorders

Mood Disorders

Anxiety Disorders

Personality Disorders

Schizophrenia

Feeling unhappy, sad or down are normal emotions

Anxiety is common and normal when

faced with a stressful situation

An enduring pattern of behaviour that deviates from the

individuals culture, has onset in

adolescence or early adulthood and

leads to distress

A thought disorder, characterized by a

history of acute psychosis and lasts

for at least 6 months

Mood disorders refer to a chemical

imbalance that causes a persistent

change in a person’s behavior and interferes with

their daily living

An Anxiety disorder is when this anxious feeling persists with

physiological symptoms and interferes with

normal functioning

Caused by changes in brain chemistry,

genetics which affects thinking,

perception, mood and behavoiur.

Mood Disorders

DepressionSAD (seasonal affective disorder)ManiaBipolar I & II

Depression

Low moodAnhedonia - lack of pleasureUnintentional Weight ChangeInsomnia or HypersomniaFatigue or Loss of EnergyWorthlessness or GuiltyThinking problemsMorbid thoughts

Depression

Is very common component of substance use and withdrawal, particularly alcohol, opioids, steroids and stimulants.

Typically takes 4-8 weeks of clean time before substance-induced depression can be ruled out

Older adults who abuse substances usually have mood disorders

Depressed persons have some preference for stimulants and alcohol

Mania

GrandiosityDecreased need for sleepTalkative or fast talkingFlight of ideasDistractibleExcessive pleasure seekingCan be brought on by stimulant use or depressant

withdrawal

Bipolar I and II

Both require having had at least a 2 week episode of depression and• a one week episode of mania (I)• 4 days of hypomania (II)

Continuum of depression

DepressionNormal

Sadness/

Grieving/Blues

Depression

BipolarManic

Normal

Depressed

Treatment of Mood Disorders

MedicationsPsychotherapyOccupational TherapyExercise

Anxiety Disorders

Panic DisorderGeneralized Anxiety DisorderSocial Anxiety DisorderPhobiasPost Traumatic Stress DisorderObsessive-Compulsive Disorder

Phobias

Technophobia - fear of technology Sciophobia - fear of shadows Decidophobia - fear of decision making Nyctophobia - fear of nights Topophobia - fear of performing (stage freight) Gatophobia - fear of cats Hydrophobia - fear of water Spermophobia - fear of germs Aerophobia - fear of flying Agoraphobia - fear of open spaces Claustrophobia - fear of enclosed spaces Gamophobia - fear of marriage Scholionophobia - fear of school Pyrophobia - fear of fire

Anxiety Disorders

Anxiety is the most common symptom of substance abusers and is now considered to be a cause of anxiety disorders much more often than as a self-medicating for underlying anxiety disorder

Using chemicals (cannabis) to cope with anxiety can weaken ability to use healthy mechanisms and create avoidance tendencies

Anxiety can be resolved in addiction treatment

Panic Attacks

A discreet period (< 30minutes) reaching a peak within 10 minutes with 4 or more of …• Palpitations, pounding heart, or fast heart rate• Sweating• Trembling or shaking• Shortness of breath or feeling smothered• Feelings of choking• Chest pain• Nausea• Feeling dizzy, light-headed, faint, or unsteady• Fear of losing control / going crazy• Numbness• Chills or hot flashes

Post-Traumatic Stress Disorder

1. Person exposed to trauma2. Event is persistently recurrently experienced

• Intrusive memories of event

• Dreams of the event

• Feeling as if they are reliving the event

• As intense distress or physiological reactivity when exposed to cues that resemble or symbolize the event

3. Avoidance of stimuli and numbing responsiveness4. Persistent symptoms of increased arousal

Anxiety Treatment

Medications preferably very short-term Cognitive Behaviour TherapyTrauma therapies to reprocess memories

Personality Disorders (most commonly disabling)

Borderline Personality DisorderAntisocial Personality DisorderAvoidant Personality DisorderDependent Personality DisorderObsessive Compulsive Personality Disorder

Obsessive Compulsive Disorder

Marked by repeated obsessions and or compulsions that are so severe that ehy interfere with everyday activities.

Obsessions are disturbing, intrusive thoughts, ideas or images that cause anxiety or distress

Examples are washers (fear contamination), checkers (repeatedly check things like locks, ovens, irons etc.), counters (ruled by magical thinking and superstitions, hoarders (people who can not throw things away)

Therapy for Personality Disorder

Medications for symptom managementPsychotherapy

Addictions

Alcohol, Heroin and other Opiate use frequently causes symptoms of depression and sometimes depressive illness.

Alcohol, and cannabis often create anxiety disorders by allowing avoidance of anxiety provoking stimuli

Cocaine addiction can resemble or create bipolar mood swings

Addiction Therapies

DetoxOutpatientInpatient ResidentialSupport Recovery, Longer Term ResidentialSelf - Help

Eating Disorders

Anorexia NervosaBulimia NervosaEating Disorders NOS

Anorexia Nervosa

Refusal to maintain normal body weight for age & height

Intense fear of weight gainDisturbance in self-evaluation of body shape

and size, denial of serious of underweightAmenorrhea in postmenstrual women

Bulimia Nervosa

Recurrent binge eating episodesRecurrent purging to avoid weight gainBinge eating and purging occur on

average, at least twice a week for 3 monthsSelf-evaluation influenced by body shape

and weight

Treatment of Eating Disorders

Medical stabilizationMedicationIndividual therapy Family Therapy- several models are being

researchedNutrition EducationTeam approach

Schizophrenia

A disturbance involving delusions, hallucinations, disorganized speech and or catatonic behaviour

Delusions are false beliefsHallucinations can be auditory, visual or any of the 5

sensesIt is also associated with a deterioration of a person’s ability

to function at work, school and or sociallyIt may begin in late adolescence or early adulthoodDrug use may initiate this change